Division of Paediatric Emergency & Critical Care, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Division of Neonatology, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2022 May-Jun;155(5&6):505-509. doi: 10.4103/ijmr.ijmr_2500_21.
BACKGROUND & OBJECTIVES: As severe COVID-19 and mortality are not common in children, there is a scarcity of data regarding the cause of mortality in children infected with SARS-CoV-2. This study was aimed to describe the all-cause mortality and COVID-19 death (disease-specific mortality) in children with SARS-CoV-2 infection admitted to a paediatric COVID facility in a tertiary care centre.
Data with respect to clinical, epidemiological profile and causes of death in non-survivors (0-12 yr old) of SARS-CoV-2 infection admitted to a dedicated tertiary care COVID hospital in north India between April 2020 and June 2021 were retrieved and analyzed retrospectively.
A total of 475 SARS-CoV-2-positive children were admitted during the study period, of whom 47 died [18 neonates, 14 post-neonatal infants and 15 children (1-12 yr of age)]. The all-cause mortality and COVID-19 death (disease-specific mortality) were 9.9 per cent (47 of 475) and 1.9 per cent (9 of 475), respectively. Underlying comorbidities were present in 35 (74.5%) children, the most common being prematurity and perinatal complications (n=11, 24%) followed by congenital heart disease (n=6, 13%). The common causes of death included septic shock in 10 (21%), COVID pneumonia/severe acute respiratory distress syndrome in nine (19%), neonatal illnesses in eight (17%), primary central nervous system disease in seven (15%) and congenital heart disease with complication in six (13%) children.
INTERPRETATION & CONCLUSIONS: Our results showed a high prevalence of underlying comorbidities and a low COVID-19 death (disease-specific mortality). Our findings highlight that mortality due to COVID-19 can be overestimated if COVID-19 death and all-cause mortality in children infected with SARS-CoV-2 are not separated. Standardized recording of cause of death in children with SARS-CoV-2 infection is important.
由于严重的 COVID-19 和死亡率在儿童中并不常见，因此有关感染 SARS-CoV-2 的儿童死亡原因的数据稀缺。本研究旨在描述在印度北部一家三级保健中心的儿科 COVID 病房中收治的感染 SARS-CoV-2 的儿童的全因死亡率和 COVID-19 死亡（疾病特异性死亡率）。
回顾性检索并分析了 2020 年 4 月至 2021 年 6 月期间在印度北部一家专门的三级保健 COVID 医院收治的 SARS-CoV-2 感染非幸存者（0-12 岁）的临床、流行病学特征和死亡原因数据。
在研究期间，共有 475 例 SARS-CoV-2 阳性儿童入院，其中 47 例死亡[18 例新生儿，14 例新生儿后婴儿和 15 例儿童（1-12 岁）]。全因死亡率和 COVID-19 死亡（疾病特异性死亡率）分别为 9.9%（47/475）和 1.9%（9/475）。35 例（74.5%）儿童存在潜在合并症，最常见的是早产儿和围产期并发症（n=11，24%），其次是先天性心脏病（n=6，13%）。常见的死亡原因包括 10 例（21%）感染性休克、9 例（19%）COVID 肺炎/严重急性呼吸窘迫综合征、8 例（17%）新生儿疾病、7 例（15%）原发性中枢神经系统疾病和 6 例（13%）先天性心脏病伴并发症。
我们的结果显示，存在潜在合并症的儿童比例较高，COVID-19 死亡（疾病特异性死亡率）较低。我们的研究结果表明，如果不区分感染 SARS-CoV-2 的儿童的 COVID-19 死亡和全因死亡率，可能会高估 COVID-19 死亡。标准化记录感染 SARS-CoV-2 的儿童的死亡原因很重要。
